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DocuSign Envelope ID: C9AF5D7E-E8F1-4FC2-8917-EA301453E701 <br /> Iff1b, Policy Number: MPU1 371 P <br /> MAPS� <br /> SrREL'r THIS ENDORSEMENT CHANGES THE POLICY <br /> AMERKA PLEASE READ IT CAREFULLY <br /> GROUP BUSINESSOWNERS POLICY CHANGE ENDORSEMENT <br /> MAIN STREET AMERICA ASSURANCE COMPANY <br /> I End No. 0 0 4 <br /> Named Insured. ELOY ALVAREZ Endorsement Effective Date: 05-1,9 <br /> Agent Narne: NORTHEAST AGENCIES INC CL SC Agent N a 314026 <br /> This endorsement will not be used to decrease coverages, increase rates or cleductbles or alter any terms or conditions of <br /> covers unless at the sole re nest of the insured, <br /> BUSINESSOWNERS POLICY CHANGE DESCRIPTIONS <br /> THF POLICY IS ,AMENDED AS FOLLOWS * <br /> THE F01,1,0WING ADDITIONAL IN­FEREST (,LIAR-S'FATE', OF, POLITICAL <br /> SUBDIVISIONS - PERMI'J'S) HAS BEEN ADDED "1'0 THE POLICY: <br /> ORANGE COUNTY <br /> PO BOX 8181 <br /> HILLSBOROUGH, NC 27278-8181 <br /> ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME <br /> The changes described result in a change in prerrdurn as follows: <br /> Ej No Changes 1[-] To be Adjusted at Audit I additional NO CHARGE, Return NC) CHARGE <br /> Changes in Taxes,, Fees and Surcharges <br /> Additional Return <br /> Countersigned By: AUTHORIZED AGENT <br /> BPM CHANGE 0197 <br /> INSURED UPY <br />